Provider Demographics
NPI:1689886137
Name:LINDA MUNRO PSY D PA
Entity Type:Organization
Organization Name:LINDA MUNRO PSY D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:NAIL
Authorized Official - Last Name:MUNRO
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:478-396-3084
Mailing Address - Street 1:655 7TH ST
Mailing Address - Street 2:BLDG 700/700-A
Mailing Address - City:ROBINS AFB
Mailing Address - State:GA
Mailing Address - Zip Code:31098-2227
Mailing Address - Country:US
Mailing Address - Phone:478-222-4834
Mailing Address - Fax:478-327-8400
Practice Address - Street 1:655 7TH ST
Practice Address - Street 2:BLDG 700/700-A
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098-2227
Practice Address - Country:US
Practice Address - Phone:478-222-4834
Practice Address - Fax:478-327-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4016286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73495Medicare PIN